How to Keep Your Bones Strong as You Age

From the WebMD Archives

It's true that we lose bone as we age. Bone loss can cause osteoporosis, where bones can become so thin that they break. Fractures from osteoporosis are a leading cause of disability. The good news: Osteoporosis isn't a natural part of aging -- there’s plenty you can do to keep your bones strong and healthy.

The first step is getting all the nutrients you need for proper bone growth. "A healthy diet can significantly reduce the risk of bone loss and osteoporosis," says Kathleen Zelman, RD, director of nutrition for WebMD. "And it's never too late to start."

2 Critical Nutrients for Bones: Calcium and Vitamin D

Calcium is a crucial building block of bone tissue. Vitamin D helps the body absorb and process calcium. Together, these two nutrients are the cornerstone of healthy bones.

The Institute of Medicine recommends 1,000 mg of calcium a day for most adults and 1,200 mg/day for women after menopause and men after 70. Milk and other dairy products are excellent natural sources of calcium. You'll hit the mark by eating three servings of dairy products a day. Other good food sources of calcium include calcium-fortified orange juice, leafy green vegetables, and broccoli. If you don't eat those foods regularly, talk to your doctor about calcium supplements.

Researchers believe that most Americans fall short on vitamin D, a critical nutrient. Your body makes it naturally when your skin is exposed to sun. "In many parts of the country, especially during the winter months, the sun is too weak to generate vitamin D," says Zelman. Older people especially are at high risk of vitamin deficiency. The reason: the body becomes less efficient at producing vitamin D as we age.

Vitamin D deficiency is common in all ages and few foods contain vitamin D. Milk and some brands of yogurt are fortified with D. Vitamin D deficiency is defined as a 25(OH)D below 20 ng/ml and vitamin D insufficiency as a 25(OH) D of 21–29 ng/ml.

Adults need at least 600 IU of vitamin D per day for bone health, but some people may need up to 2000 IU to increase blood level of 25 (OH) vitamin D consistently above 30ng/ml. Adults 70 years and older need 800 IU of vitamin D a day to prevent falls and fractures.

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Bone Strength Goes Beyond the Nutrition Basics

Healthy bones depend on more than calcium and D. "We now know that many nutrients are essential to maintaining bone," says Katherine Tucker, RD, PhD, chair of the department of health sciences at Northeastern University in Boston. Her research and that of others point to key roles for protein, vitamin B12, magnesium, vitamin C, and other nutrients.

"Unfortunately, the diets of many older people fall short on some of these nutrients," says Tucker. "So even if they’re getting calcium and vitamin D, they’re still losing bone."

A Diet of Whole Foods

The best way to get all the nutrients you need is to fill your plate with whole foods. Nuts, beans, whole grains, and fruit and vegetables are naturally rich in an array of nutrients essential to healthy bones. Tucker’s research suggests that fruits and vegetables are just as important as dairy products for bone health.

Choosing nutrient-rich foods is particularly important as you get older since most people's calorie requirements go down. "The challenge is to get as much nutrition into a limited number of calories," says Zelman. She suggests a few simple tips:

  • Avoid highly processed foods. Processing strips some foods of their natural nutrients. Even when vitamins or minerals are added back, processed foods usually lack the full array of nutrients found in natural foods.
  • Choose whole foods. Whenever you have the choice, go for foods with whole grains, which are far richer in nutrients linked to bone health. Look at the ingredient panel of breads, cereals, and other products made with grain. The first ingredient should be a whole grain.
  • Go for variety. "Especially if you’re cooking for yourself, it’s easy to get stuck in a rut," says Ruth Ann Carpenter, RD, author of Healthy Eating Every Day. "That rut can mean you’re missing out on the variety that ensures a healthy diet." Try a new grain, such as bulgur or quinoa. Choose vegetables from across the spectrum of colors, from leafy greens to red sweet peppers. A colorful diet, nutritionists say, will help ensure a balance of nutrients necessary for good bone health.

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When to Reach for Calcium or Vitamin D Supplements

Even the healthiest diet may not provide all the nutrients you need for bone health. If you don't drink milk, for instance, you may be falling short on calcium. Multivitamins or single supplements of specific nutrients can help fill in the gaps. But before you start taking any supplement, it's wise to talk to your doctor.

How to Strengthen Bones With Exercise

Along with a healthy diet, physical activity is crucial for strong bones. Most people think of exercise as a way to strengthen muscles. "But weight-bearing exercises also put stress on the bones attached to those muscles, stimulating them to rebuild themselves," says Dori Ricci, an exercise specialist in New Jersey.

The most effective exercises for strengthening bones are those that involve weights. Some exercises use the body's own weight, such as deep knee bends or push-ups. Others involve weights that are held, such as dumb-bells used for bicep curls. If you have broken a bone because of osteoporosis or are at risk of breaking a bone, you may need to avoid high-impact exercises such as jumping, stair climbing, or dancing, Instead do low impact exercises such as elliptical machines or stair step machines. Another way to exercise muscles is using stretch bands that provide resistance. Here's what to consider:

Develop a whole body routine. "Strength-building exercises benefit the specific muscles and bones being exercised," says Ricci. "So it’s important to develop a routine that involves all the major muscle groups. Each muscle group should be exercised at least once a week."

Start slowly. Strength-building exercises may sound daunting, especially if you haven't exercised before. "It's wise to start an exercise with no weight or very little weight and then slowly add heavier weights," says Ricci. In programs she develops for older clients, she divides muscle groups into three groups: legs and shoulders, back and biceps, and chest and triceps. She recommends at least 30 minutes of weight-bearing exercises for each group, once a week.

Stay with it. "A lot of people are anxious about weight-bearing exercises at first," says Ricci. "But once you get into it, you’ll find that you love feeling more stamina and greater strength."

Along the way, you'll also be building stronger bones.

WebMD Feature Reviewed by Arefa Cassoobhoy, MD, MPH on October 14, 2013

Sources

SOURCES:

Kathleen Zelman, RD, director of nutrition, WebMD. 

National Osteoporosis Foundation 

Katherine Tucker, RD, PhD, Northeastern University.

Ruth Ann Carpenter, RD, author of Healthy Eating Every Day.

Institute of Medicine.

Dietary Reference Intakes for Older Adults.

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